I had an email recently [notice the common thread from my previous post..?] from a reader who wanted to know more about the kind of therapy that I am currently doing: attachment-based psychoanalytic psychotherapy. [Just drips off the fingertips when you type it out in full, doesn’t it..?]. So – after some thinking – I wrote her back, and I thought I would use a modified version of what I wrote in that email as a basis for this post, because it turned out to be a really good thinking exercise for me. What is it like to be in attachment-based therapy? In what way is it different to the more classic psychoanalytic therapy I did before?

Before I go on to recreate my email reply I want to make very clear something which I failed to highlight in my original response, namely that it is attachment-based therapy that I am doing. This has absolutely nothing to do with the highly controversial pseudo-“therapeutic” approach known as ‘ attachment therapy’, which is something I would never choose to do, nor would ever recommend to anyone anywhere, as it is, in my view, nothing but a re-scripted form of abuse trying to pass as therapy, practised on already traumatised children.. Strong words, I know, but then I do feel very strongly about calling something therapy that is clearly not therapeutic.. And I really don’t want anyone to think that this is the kind of treatment I’m undergoing three times a week.

Now that’s out of the way – let’s cut to the email and talk about attachment-based therapy:

Having previously been doing more classic psychoanalytic therapy with A., I would say that – in my experience – the main difference that the “attachment based“-part offers is that it is a very open and relational approach to therapy. Of course, all therapy is about forming a solid relationship with your therapist, but attachment based therapy puts a very heavy emphasis on building a real and genuine relationship with your therapist. It is an open invitation to form a strong attachment with your therapist, an opportunity to learn that it is OK – and safe – to attach to someone else, to allow yourself to be cared for and to depend on another person. I think this is an incredibly valuable [and often unbearably frightening!] thing to be offered, particularly for people who have not had the opportunity to experience safe and secure attachments during childhood, whether through having been given up for adoption, through abuse or through having had parents who simply lacked the skills needed to be the safe adult that all children need and deserve.

I suppose that being in attachment based therapy is a little bit like being re-parented. Not in a being-bottle-fed-again kind of way, nor in the sense that you don’t have to take responsibility for yourself or your actions, but in that you are given the opportunity to learn [ever so slowly!] to trust that someone else can really and truly be there for you, to be allowed the luxury of finding out that you are not ‘too much’ and that you can be loved and accepted for all that you are, including the bits that you feel ashamed of, the bits that you would rather keep hidden, even from yourself.

In our nearly two years together [two years? already!?] P. and I have slowly built our relationship through mutual openness. I try to be as open as I can with her, and she, too, shares openly of herself with me. I don’t mean that she self-discloses lots, but that she shares of who she is with me. The best way I can explain it is that rather than putting on her ‘therapist hat’ for me at the start of each session, she simply is who she is all the way through, and part of that is that she is a trained therapist, and she utilises the skills she has gained through her therapist training in our relationship. [I have no idea if this makes any sense to you, but I hope it does].

P. talks directly and honestly with me – no ‘blank canvas stuff’ – and I try to do the same. In fact, it is often through her openness that I dare do the same. P. has even talked about the love she feels for me and the special place I have in her heart, [now, that’s a Special Kind Of Scary, believe you me!] and she will tell me if something I say moves her or makes her angry or sad or confused or proud or frustrated, etc etc etc. And that really is one of the greatest things about our therapy, because it gives me a model to copy, makes it OK for me to tell her if something she has said or done moves me or makes me angry or sad or confused or proud or frustrated; it is very similar to how a parent who allows themself to show and share a wide range of emotions with their child, teaches the child that it is fine to do the same, that all feelings are OK and can be accepted. To me, this is also one of the more obvious differences between the psychoanalytic therapy I was doing with A. and the attachment based therapy P. and I are doing – the way P. provides a model to follow.

One of my absolute favourite things about P. is that she’ll laugh out loud if I say something she finds funny – with no attempt at all at trying to hold back her response in favour of analysing my joke. Of course there is a fair bit of analysing going on in our therapy, too, but it is much more a case of us jointly thinking about why certain things come up and looking together at why other things don’t, than P. silently sitting there analysing my every word. And if I sense that P. is hesitating to say something to me, or seems upset by something I’ve said, we can talk about that, too. – Trust me, she doesn’t get let off the hook if I think she is holding back! Or if she is bringing attention to something more than I feel is warranted, for that matter.

Another important aspect of our relationship is that P. is constantly reassuring me that she is there for me and that she can cope with what I tell her [in the same way that a secure parent would reassure their child]. P. also encourages all the different parts of me [Little S, Adult Me, bob etc] to take part in our therapy and to share their feelings, so that we can begin to understand the dynamics inside, to see how the different parts work together and what causes friction and inner conflict. I’m not talking about dissociative personalities here, just the very ordinary internal structure we all have – the inner child, the responsible adult, the raging teenager etc etc.

Because I sometimes find it difficult to allow Little S. to speak in session [Adult Me tends to get embarrassed by her childish neediness and her desire to have a mummy who will look after her and love her] P. encourages all the different parts to email or text her in between sessions and over weekends, so that those parts that perhaps couldn’t be heard in the session have a chance to share, too. And that really has been an invaluable tool which has added a whole different dimension to our therapy.

When I [or Little S. or bob] contact P. outside of session she will respond to texts and emails not just with a quick one-liner saying “We’ll talk about it on X-day”, but instead she responds in full to whichever part contacted her, sharing her thoughts, and also reassuring me that she really wants me to share what’s going on with me between sessions, that she wants to know.. Just like a parent would. Or at least should. – I won’t lie, it has taken me a looooong time to feel OK with reaching out to P. between sessions, in all honesty a lot of reassurance is still needed – but, thankfully, she is happy to provide that, and that is so helpful to me, because I do need that reminder regularly. Very regularly. We’re not talking P. telling me that it is OK to write her once or twice or even fifty times, we’re talking at the end of most sessions and after most of my emails..

Also, P. knows me well enough by now to know that – despite her constant reassurance – one of my greatest fears is that I will break her through asking too much of her, or through sharing too much Bad Stuff, and that those fears tend to crop up immediately after a difficult session, so she will often save a few minutes towards the end of a session for me to ‘check her out’. [As I’m writing this, I can hear her ever so gently asking ‘How are you feeling now? Do you need to check how I’m feeling..?’]

There is of course lots and lots more to write about doing this style of therapy; there is no way that I could fit it all into a single post, but I do hope that I have, through my rather rambling writing, given you at least a little bit of an insight into what being in attachment based therapy can be like.

Of course, this is just my experience – someone else might have a completely different idea of what attachment based therapy is like, and – as I know I’ve written on my blog previously – therapy is far less to do with the theoretic approach – that’s merely a backdrop – and much much more to do with the relationship and chemistry you build with your specific [or, in my case, terrific ;) ] therapist.

But I suspect y’all knew that already – ‘cause you’re a clever lot!

All the very best,

xx

PS. You are more than welcome to disagree with my opinion of attachment ‘therapy’, just don’t expect me to change my view about this particular subject..

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6 responses

She does sound terrific. I heard an anecdote about a psychiatrist (from a nurse who overheard him say this) in a psychiatric hospital: “Keep my patients away from me!” P, in contrast, seems to be a winner in terms of her availability.

Thanks Gerry , [I feel that after all these years of exchanging comments I can take the liberty of calling you that].
Yes, P. truly IS terrific. But, as I just wrote in an email to another reader, as much as she encourages me to share as much and as often as I want to, she also maintains clear boundaries, and she will respond to my emails when she has the time she feels she needs to write a proper reply [ie not jumping on her laptop within five minutes of me emailing], and I find that incredibly reassuring and comforting. She retains parental responsibility for our relationship, so that I don’t have to; I know that she won’t offer me more than what she feels able to, but what she does offer is a LOT!
I actually sent her the link to this post, because we talked about the email I wrote to my reader about our therapy in our latest session, and I thought she might be interested to read in full what I wrote. Makes me a wee bit anxious, but I’m sure some good stuff will come out of it.
Take good care of your Self,
xx

PS. My response to that nurse would be: “Keep that person away from patients!”

Very eloquently put and resonates in many ways to how I would describe my attachment-based psychoanalytical psychotherapy. Think it took me the first two years to cement that phrase in my head so that I could tell a favoured few, if I was asked, where on earth I disappeared to twice a week! My best wishes, as always.

And thank you once again for taking the time both to read and to comment on my blog. It means a lot. [I know I say that every time, but I do so with good reason: it’s true!]

I’m glad that you found that what I wrote about being in attachment-based therapy resonates with your experience. As much as I write that someone else’s experience might be radically different to mine, it IS comforting to hear that others share a similar experience! [Always that slight worry that someone else is going to say ‘You’ve completely misunderstood what a-b therapy is about, you plonker!].